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Bon Secours Virginia Creating a Culture of Wellness 2012 Today’s Discussion – Creating a Culture of Wellness – Personal Health Assessment Results – Becoming Accountable for Our Care – Employee Wellness Strategies 2 Program Guiding Principals 1. Create a culture of Wellness and Wellbeing that empowers employees to make healthier choices at home and at work 2. Decrease healthcare costs through prevention, wellness and interventions 3. Provide programs and services to motivate employees to make life-long behavioral changes. 4. Collect and analyze data to develop, support and maintain program design and optimal results. 5. Decrease controllable risk factors. By coordinating and centralizing the care of employees, companies can take control of medical costs and tailor services to meet employees needs. 3 Bon Secours trend reduction: $159M savings over 5 years Every 1% reduction in trend saves average $5.5M per year 2011-2015 • Value-Based Design • Patient-Centered Medical Home • On Site Clinic Annual Cost (in millions) • Total Health Management • Integrated Health and Disability • Best in Class Vendors • Decision Support/Data Warehouse • Employee ACO TREND High Cost of Poor Health • HYPERTENSION: Hypertension is associated with a cost of $392 per employee per year. • DIABETES: Annually, an employee with diabetes will cost $13,243 on average, while an employee without diabetes costs only $2,560 on average • ASTHMA. Annual per capita employer expenditures for asthmatic patients is approximately 2.5 times those for control subjects ($5,385 vs. $2,121, respectively). • The estimated direct cost of obesity to the medical plan for Bon Secours Virginia is: • $5.3 Million or $1429/employee/year. • Indirect costs are related to absenteeism and productivity loss. • Research shows that as the weight of a worker increases, productivity decreases and absenteeism increases. • 5 Understanding our Challenges A Small % Drives Cost • 20% of the employee population Population Costs drives 80% of current year cost • Poor lifestyle choices drive 50% -70% of health care cost Determinants of Health A 1% reduction in employee utilization = $750,000 Source: Institute for the Future, Centers for Disease Control and Prevention 6 Personal Health Assessment Results Personal Health Assessment (PHA) • Prior to 2011 40% of employees participated in the PHA. • Beginning in 2012 the PHA was aligned with the Health Plan and employees who did not participate paid $800.00 more per year for Health Insurance. • Coupled with a strong incentive and an equally robust communication and branding strategy, in 2012 95% (12,350) of employees participated in the PHA process. 8 PHA Participation and Risk Stratification Hampton Roads Richmond Risk Category Count Percent Count Percent Low Risk (0-2 Risks) 1221 42% 2738 44% Moderate (3-4 Risks) 1043 36% 2048 33% High (5+ Risks) 663 23% 1378 22% PHA Participation 2927 89.2% 6073 95% Average # Risk Factors 3.10 3.02 9 Top 8 Controllable Risks Overweight (BMI >27.5) 55% Sedentary Lifestyle 48% Hypertension 35% High Cholesterol 36% Low HDL Cholesterol 17% High Stress 17% Low Job Satisfaction 15% Low Life Satisfaction 11% 10 Becoming Accountable for Our Care Building an Employee ACO for Bon Secours Virginia Health System ACO Program Description The ACO pilot targets the highest risk employee population in Bon Secours Virginia. This program is strictly voluntary and operates outside the BSHSI benefit plan. In order to attract and retain a significant number of this targeted group, it is necessary to offer financial incentives. The incentives are paid out over the course of the program as the employees reach clinical and lifestyle change milestones. Each employee who participates in the program will be assigned a Good Health Navigator at InHealth. The Navigator is responsible for establishing goals and tracking progress made throughout the course of the ACO program. 12 Management of High Risk • Partner with high risk employees to support changes in lifestyle and navigate to a Medical Home • Telephonic Health Coaching • Goal oriented and incentive based. • Confidential and Voluntary – Diabetes – Hypertension – Asthma 13 Early Results Employee Wellness Focus 2012 Bon Secours Virginia Employee Wellness Model of Care Physical Activity Tobacco Cessation: Quitline or Freshstart in person class Weight Management: Referral into weight loss program based on BMI Communication Web-based information Targeted messaging and emails Physical Activity Physical Activity reminders of prevention screenings If you are Diabetic and/or Hypertension, If you are Diabetic and/or Hypertension, Physical and disease prevention Group exercise classes made available assessment and group training sessions available over Weekly wellness tips and Bimonthly a 3 month period then a reevaluation. Good Life Newsletter Incentive Program Complete the PHA and Wellness plan Same as low risk plus Same as low risk plus Complete all age related Communication Communication recommended screenings. Examples: • Quarterly tailored messages, email • Invitational letter from EWS mailed to home with a Physical with PCP, Annual and home mailing on specific risks follow up phone call from CENVANET to those who Mammogram (or baseline for women such as hypertension. have not responded. 35-40) and Pap for women or Incentive Program Incentive Program Prostate Exam and PSA for men • Group Coaching (Healthy Weigh, • If Diabetic, Hypertensive, Asthma or Back (Ortho) Complete Self-care workshop and Compass to the Good Life) complete 6 coaching sessions with CENVAT for complete personal health record for • Complete 1-2 coaching Sessions disease and medication management or enroll into future visits to PCP either in person or telephonic disease management program such as DTC or • Complete 2 Healthstream/Webinars Cardiac Wellness. based on wellness goals • Other high risk employees not identified in the 4 groups above will work with the nurse navigator SeIf-Care/Mental Health 17 2012 Targeted Wellness Programs Accountable Care Interventions Healthy Eating and Foods • Driving employees to Primary Care • Nutrition Education Physicians • Revamping Cafeterias and Vending • Patient Navigators Targeting High Risk Self Care Initiative • Take Charge of Your Health Good Health Clinic • Get a Doc and Get a Physical • Episodic care and case management Campaign of High Risk 18 2012 Targeted Wellness Programs Physical Activity Weight Management and Nutrition • Get Moving campaign • Healthy Weigh webinar based lifestyle • Stairwell campaign modification • Commit to Get Fit Campaign • Medical Weight Loss Pilot • Team Lean – “Biggest Loser” • Weight Watchers at Work Competition Tobacco Cessation • Walking paths • Reinforcement of tobacco free • Fitness challenges campus • Onsite group exercise classes • Freshstart classes (1:1, web based, • Fitness Center Discounts telephonic, group) 19 fy11 vs. fy12 Good Results • Bon Secours Richmond’s Personal Health Assessment (PHA) participants experienced a 12.10 % ↓ in medical claims while non-participants experienced a 14.80 % ↑. The total cost avoidance equals $1.5 million. • Health insurance rates have ↓ $10 per employee per month. • Participants in the Bon Secours Richmond Good Life Wellness Program showed a 43% ↓ in “Controllable Risk Factors” for a net reduction in medical claims of $1 million. • Sedentary lifestyle ↓ from 41.9 % to 38.4 %. • Average number of risk factors ↓ from 2.46 to 2.3 per employee. • Productivity ↑ by 26 % by targeting those medical conditions most affecting the work force such as migraine headaches, allergies and musculoskeletal pain. Good Results fy11 vs. fy12
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